i could go on for hours about my thoughts on the bcma and cprs systems, but i'll spare you all!
i've worked for the va for a little over a year (been a nurse for 20 years, though) and i have never had such difficulty giving and charting meds as i do with these programs. i work in an icu so i never have more than 2 patients and i get so frustrated, i could scream. i can't imagine having to deal with the bcma for a whole ward of patients!!!
i am constantly amazed at the errors that show up. it seems like the program should pick up on things it doesn't. some examples are when the exact same med in the exact same dose is ordered twice on a patient (maybe once by an intern and then re-ordered by a resident), it will show up twice on the med sheet, many times right beside each other. i've seen ridiculous orders/doses show up (last week, a resident was trying to order a vasopressin drip on a patient. we usually make them 100 units vasopressin in 100 cc's ns. he ordered vasopressin 100 units iv now. i knew what he meant...but the bcma showed up with the order just as he had written it. hopefully, all who work in my unit would know not to give that as written, but the computer (or pharmacist!!) should spit the order back for a clarification/correction.
i realize that this system is supposed to be safer, not faster. i think the theory behind the whole system is great. i just think the way it is working now is awful and much more chance of error is present. we, too, also enter the numbers in manually many times. that is due to multiple reasons, some being the drug won't scan, we have to wait for pharmacy to enter an "available bag" number (even though we have a bag in our hands!), we have to wait for a change (such as time due) by the pharmacist and sometimes, we have the right med in our hand, scan it, and an "invalid med" error message pops up. :angryfire
it would be nice to be able to change the times online without having to call pharmacy to do so. it also amazes me that after 72 hours for narcotics, and after (can't remember the exact time) for antibiotics, the orders just fall off the screen. i can't tell you how many times i've had to remind the physician that the vanc or ancef or whatever it is they think their patient has been on dropped off the orders at midnight several nights ago and the patient hasn't gotten any since. or, i look for a pain med order and there aren't any...they expired and no one has renewed them. now, i know that if the doctors renewed them in a timely manner, this wouldn't happen, but we all know that that isn't always the case. the person who initially ordered the med may be gone on vacation or done with that rotation and no one takes the inititiave to re-order. so, we call for an order and hope that the 3 or 4 days that the patient didn't get the antibiotic won't make a difference.
not that difficult, but it does take an extra 5 or 10 minutes and time is something most of us don't have enough of already while we're at work.
i'm sorry to complain so much but i get so frustrated with the whole thing because i feel like the patients aren't getting the full benefit of the technology.
anyway, i just always make sure i pay attention to all those things i learned a long time ago in nursing school
(5 rights, good documentation-which i do on the flow sheet, pay attention to your patient) and i do the best i can with the computer. it will never be my priority....the patient will!